Mehmet Oz and Steven Novella
At SBM we are highly in favor of physicians and scientists interfacing with the public, using mainstream and new media to promote the public understanding of science and to explain the modern practice of medicine. Now that Dr. Dean Edell has retired (unfortunately) from his radio show, it is probable that Dr. Mehmet Oz has the highest exposure of any media physician. I have never personally been a fan of Oz – a product of Oprah Winfrey, he has always mixed reasonable medical advice with promotion of dubious alternative health care. Harsh critics of Oz have charged him with selling out in order to promote his media career.
Regardless of his motivations, Oz has recently gone beyond coyly flirting with pseudoscience by directly promoting Joseph Mercola – a notorious internet doctor who himself promotes all sorts of pseudoscience and fear-mongering on his website. In an interview on his show, Dr. Oz praises Mercola while refraining from directly mentioning any of the more controversial positions that he takes. I will discuss the interview itself below, but first some background on Mercola.
Mercola is infamous among promoters of SBM for a number of reasons. First his website is highly monetized. While he frequently resorts to the “Big Pharma” conspiracy talk, he himself prints information on his site that supports the sales of supplements and other products. In my opinion this makes him a snake oil salesman, and everything he writes can no longer be considered objective medical advice but rather is advertising copy. I have no problem with monetizing websites to pay for bandwidth, as long as it’s within reason. But at some point you cross a fuzzy line where the website content is there to support sales, rather than the other way around – and Mercola is way past that line.
But far more importantly, the information on Mercola’s website is not science-based. Mercola frequently engages in rank fear-mongering – promoting every preliminary study that may suggest a possible connection as if it were a proven health risk.
I have been most critical of Mercola for his anti-vaccine stance. He recently joined with anti-vaccine activist Rosemary Fischer to attack the flu vaccine. Last year he was warning his readers away from the H1N1 vaccine citing fears that it would cause an epidemic of Guillaine-Barre Syndrome (GBS). This epidemic never appeared – despite active monitoring, there were no excess cases of GBS due to the H1N1 vaccine. Mercola never bothered to correct his prior fear-mongering. He just went on to the next one – warning his readers about a connection between vaccines and narcolepsy. However this fear did not hold up to replication either.
The pattern of Mercola’s writings is clear. Any bit of information, no matter how flawed, preliminary, or tenuous, that suggests a fear about mainstream medicine he promotes as if it is a proven fact. He also follows the same pattern with any pre-clinical or preliminary evidence that suggests a possible role of any food or supplement in the prevention or treatment of a disease. In the absence of well-designed clinical trials, he happily extrapolates from this preliminary evidence to sell specific products with health claims.
In short, in my opinion Mercola is a dangerous medical crank.
Dr. Oz has chosen to promote Mercola as a cutting edge controversial doctor – the doctor “your doctor does not want you talking to.” Oz is taking the role of peace-maker – bringing the two sides together. This goal probably sells well to the public, as it appeals to our sensibilities of fairness and democracy, but it is ultimately anti-scientific and hopeless. You will have as much luck bringing together biologists who understand and accept evolution with creationists. There are fundamental and mutually exclusive differences in method and philosophy.
But Oz acts as if (whether or not he truly believes it) science-based medicine and CAM are just different traditions or approaches, both equally valid. And that is precisely why Oz, as a media doctor, is so dangerous himself – such an attitude white-washes the very real deficiencies of CAM. The interview with Mercola is a perfect example of this.
As an interviewer, Oz did a terrible job. He lofted the proverbial softballs at Mercola, and even when they suggested a criticism he only provided Mercola with an opportunity to answer his critics – but then never followed up, and never hit Mercola with any examples of his pseudoscience (like those above). It was a honeymoon interview, useful for promoting Mercola but not providing insightful or useful information to his viewers.
For example he brought up Mercola’s monetizing of his website, without putting it into context. In response Mercola said that the difference between his website and “Big Pharma” is that his products are natural (which is completely irrelevant) and that his products never killed anyone (which is a bold claim that Mercola cannot possibly know). It is, in fact, highly likely that the information provided on Mercola’s website does have a body count. He has scared readers away from vaccination, a proven safe and effective preventive measure. Selling products with the claims that he does encourages some readers to rely upon unproven and likely ineffective treatments instead of proven treatments. Even in the absence of direct harm (which cannot be assumed for all products) there is the potential for tremendous indirect harm. Oz let Mercola get away with his claims with no counter.
As an example of Mercola’s typical behavior, Oz let him promote on his show coconut oil to treat and prevent Alzheimer’s disease. The clinical evidence for this is nonexistent. It is based on wild extrapolation from some basic science research showing that, for example, diabetic rats who were hypoglycemic had improved cognitive function when fed medium chain triglycerides, because the brain can metabolize ketones. The chance that this research has any applicability to Alzheimer’s disease is so remote as to be laughable. Perhaps there might be a distant connection that will emerge from research, but the current connection is so tenuous that making clinical claims based upon this evidence is best characterized as pseudoscience.
That is the cutting edge CAM that Dr. Oz praises Mercola for. In this case, and many others, it’s not even original to Mercola – it’s just recycled nonsense from other sources.
Conclusion
If there were any doubt as to the intellectual integrity and scientific legitimacy of Dr. Oz as a media doctor, he has erased all doubt with this interview of Mercola. It was an incompetent interview from a journalistic perspective. Oz never brought up any truly useful information – anything that would have helped his viewers make an informed decision about Mercola. It was, if anything, shameless promotion.
The interview also makes Dr. Oz’s intent clear – to bring together legitimate science-based medicine and the entire spectrum of nonsense, pseudoscience, and dubious practice that is loosely collected under the umbrella of CAM.
